Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

The discrimination against nurse practitioners must stop

Cristina Carballo-Perelman, MD
Physician
January 10, 2019
23K Shares
Share
Tweet
Share

I have been a neonatologist for 30-plus years. Throughout my career, nurses and neonatal nurse practitioners (NNPs) have guided me, assisted me and comforted me through difficult patient care issues that arose. Even more importantly, they allowed me to leave the neonatal intensive care unit (NICU) without worrying about how my patients were being taken care of.

I am writing this because our profession (MDs and DOs) continue to devalue these professionals despite the quality care they provide to our patients in our absence. I have personally witnessed during my tenure practicing in the hospital setting how physicians poorly treat nurses, speak condescendingly to them and often demean them amongst themselves, telling off-color jokes or making lewd comments about their appearance.

Nurses and NPs are not medicine “lite.” The vast majority, especially after the 1990s, did not go into their respective professions because they couldn’t get into medicine or used their nursing careers as stepping stones to enter medical school. That may have been a more common phenomenon a few decades back, when women in medicine were a rarity and nursing was seen as a pseudo-profession. This is obviously not the case anymore.

Now, both men and women, decide on a career in nursing because it is their passion. Those that choose a nursing career understand the difference between how physicians and nurses practice and what both professions offer to patient care. Essentially and simply put, doctors mostly diagnose while nurses administer care. Yes, one could say that without physicians, nurses could not administer care. However, without the nursing profession, patients would not get the care the physicians’ order.

It is the above experiences that I have personally witnessed, which drives me to explain why this continues to happen and how we, as physicians, can and should change the culture.

I believe that the origin of treating nurses as inferior to doctors resulted from, in the distant past, nurses practicing without needing a bachelor’s degree. Students were allowed to go to nursing school after high school, graduating with a degree in nursing. This has completely changed over at least the last 30 years. Nurses not only are required to have a bachelor’s degree, but many are encouraged to pursue a masters. Those nurses that go on to receive an advanced practice degree now receive a doctorate, either as a PhD or as DNP (doctorate nurse practitioner). The past discrimination against the nursing profession due to what some believed to be “inadequate” education can no longer be used to discredit this noble profession. Yet the stigma of “poorly educated” continues to be used as a trump card.

I believe that the elitism that continues to be taught in medical school feeds this discriminatory pattern of interaction with nurses, despite the common knowledge that nurses now practice with at least a bachelor’s degree if not more.

It is imperative that we as physicians be tasked with assisting nurses to become empowered within their profession. By empowering nurses to be an equal partner in the health care team, studies have shown that nursing job satisfaction rises, leading to improved patient care. Isn’t that what we, as physicians want?

So how do we stop this type of discriminatory behavior and elitism? How can we help support the nursing profession so that they begin to be treated as the equal partners of a health care team that they truly are? That, of course, is a difficult question to answer as it requires a change in culture, which requires the perpetrators of poor behavior to change said behavior. More importantly, those who require changing their behavior need to acknowledge and accept that their behavior is wrong before they can accept the need to change it! Education is the key to change.

I believe educating new physicians in training — whether in medical school and/or residency — of the value nursing brings to the health care team, will be the key to help them understand and treat nurses with the equal respect they deserve. Furthermore, it needs to be emphasized to these young doctors, that the knowledge nurses possess include not only how to care for patients but also their understanding of the pathophysiology behind the disease process and treatment plan. Moreover, the skills they have are as important towards the healing of a patient as are those of the MDs.

To assist physicians who are in the middle of their career or even later, to learn how to treat nurses as their equals within the health care team, the education needed to accomplish this may be more difficult to impart. Many may not understand that their perception, and therefore treatment of nurses is wrong and needs to change. This particular group’s mindset is that they, the physicians, can talk down to the nursing staff because of their continued belief that nursing training is inferior to theirs. How could nurses ever be considered as equal members of the health care team?

These group of physicians, will require intense new education, education not too dissimilar to learning about EMRs, HIPAA, IRBs, etc. Learning may need to be accomplished through CME courses and should be required by health care corporations as well as hospitals so that physicians can be allowed to continue to practice. Certainly we, as physicians, put limitations on our own profession, when standards for safe practice are not met. Why would learning how to interact appropriately with nurses be any different? After all, if nurses are treated poorly — patient care suffers.

Therefore, I would like us, as a group, to begin the journey towards understanding the strengths that nurses within the health care team possess. Let’s celebrate these strengths daily. In this way, patient care can be impacted positively, and outcomes improve across the board.

Cristina Carballo-Perelman is a neonatologist and can be reached at her self-titled site, Cristina Carballo-Perelman, and on Twitter @ccperelman.

Image credit: Shutterstock.com

Prev

Your first 24-hour shift

January 10, 2019 Kevin 1
…
Next

MOC harms physicians in surprising ways

January 10, 2019 Kevin 4
…

Tagged as: Hospital-Based Medicine, Nursing

Post navigation

< Previous Post
Your first 24-hour shift
Next Post >
MOC harms physicians in surprising ways

More by Cristina Carballo-Perelman, MD

  • A post-COVID medical world

    Cristina Carballo-Perelman, MD
  • The impact of COVID-19 on human kindness

    Cristina Carballo-Perelman, MD
  • Entitlement, arrogance, and isolation in modern-day medical practice

    Cristina Carballo-Perelman, MD

Related Posts

  • How nurse practitioners can expand abortion access

    Vanessa Shields-Haas, RN
  • Nurse practitioners will save primary care

    Leah Hellerstein, LCSW
  • Why nurse practitioners train on the backs of physicians

    Lynn McComas, ANP-C
  • Independent practice: Nurse practitioners respond

    Rebekah Bernard, MD
  • Nurse practitioners! Tips for negotiating your first job

    Monica Elston, FNP-BC
  • Independent practice: Both nurse practitioners and physicians should be outraged

    Rebekah Bernard, MD

More in Physician

  • Dr. Glaucomflecken for president!

    Aaron Morgenstein, MD & Amy Bissada, DO & Corinne Sundar Rao, MD
  • What is driving physicians to the edge of despair?

    Edward T. Creagan, MD
  • Do residents deserve the title of physician?

    Anonymous
  • When an MBA degree meets medicine: an eye-opening experience

    Arthur Lazarus, MD, MBA
  • The hidden gems of health care: Unlocking the potential of narrative medicine

    Dr. Najat Fadlallah
  • The dark side of immortality: What if we could live forever?

    Ketan Desai, MD, PhD
  • Most Popular

  • Past Week

    • The real cause of America’s opioid crisis: Doctors are not to blame

      Richard A. Lawhern, PhD | Meds
    • The struggle to fill emergency medicine residency spots: Exploring the factors behind the unfilled match

      Katrina Gipson, MD, MPH | Physician
    • Healing the damaged nurse-physician dynamic

      Angel J. Mena, MD and Ali Morin, MSN, RN | Policy
    • What is driving physicians to the edge of despair?

      Edward T. Creagan, MD | Physician
    • Beyond the disease: the power of empathy in health care

      Nana Dadzie Ghansah, MD | Physician
    • Deaths of despair: an urgent call for a collective response to the crisis in U.S. life expectancy

      Mohammed Umer Waris, MD | Policy
  • Past 6 Months

    • The hidden dangers of the Nebraska Heartbeat Act

      Meghan Sheehan, MD | Policy
    • The real cause of America’s opioid crisis: Doctors are not to blame

      Richard A. Lawhern, PhD | Meds
    • Nobody wants this job. Should physicians stick around?

      Katie Klingberg, MD | Physician
    • The vital importance of climate change education in medical schools

      Helen Kim, MD | Policy
    • The fight for reproductive health: Why medication abortion matters

      Catherine Hennessey, MD | Physician
    • Resetting the doctor-patient relationship: Navigating the challenges of modern primary care

      Jeffrey H. Millstein, MD | Physician
  • Recent Posts

    • The surprising power of Play-Doh in pediatric care: How it’s bringing families together

      Alexander Rakowsky, MD | Conditions
    • Breaking free from gaslighting [PODCAST]

      The Podcast by KevinMD | Podcast
    • The pros and cons of using ChatGPT for your health care needs

      Liudmila Schafer, MD | Tech
    • Dr. Glaucomflecken for president!

      Aaron Morgenstein, MD & Amy Bissada, DO & Corinne Sundar Rao, MD | Physician
    • What is driving physicians to the edge of despair?

      Edward T. Creagan, MD | Physician
    • Do residents deserve the title of physician?

      Anonymous | Physician

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

View 28 Comments >

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

CME Spotlights

From MedPage Today

Latest News

  • How Did Pulse Oximeters Perform in Black Kids?
  • Coffee and Heart Function; Ionizing Radiation and CVD
  • Health Inequity Should Be Labeled as a 'Never Event'
  • Healing the Damaged Nurse-Physician Dynamic
  • Doc Moms, Mind the Gap -- $3M Earning Difference by Sex

Meeting Coverage

  • Switch to IL-23 Blocker Yields Deep Responses in Recalcitrant Plaque Psoriasis
  • Biomarkers of Response With Enfortumab Vedotin in Advanced Urothelial Cancer
  • At-Home Topical Therapy for Molluscum Contagiosum Gets High Marks
  • Outlook for Itchy Prurigo Nodularis Continues to Improve With IL-31 Antagonist
  • AAAAI President Shares Highlights From the 2023 Meeting
  • Most Popular

  • Past Week

    • The real cause of America’s opioid crisis: Doctors are not to blame

      Richard A. Lawhern, PhD | Meds
    • The struggle to fill emergency medicine residency spots: Exploring the factors behind the unfilled match

      Katrina Gipson, MD, MPH | Physician
    • Healing the damaged nurse-physician dynamic

      Angel J. Mena, MD and Ali Morin, MSN, RN | Policy
    • What is driving physicians to the edge of despair?

      Edward T. Creagan, MD | Physician
    • Beyond the disease: the power of empathy in health care

      Nana Dadzie Ghansah, MD | Physician
    • Deaths of despair: an urgent call for a collective response to the crisis in U.S. life expectancy

      Mohammed Umer Waris, MD | Policy
  • Past 6 Months

    • The hidden dangers of the Nebraska Heartbeat Act

      Meghan Sheehan, MD | Policy
    • The real cause of America’s opioid crisis: Doctors are not to blame

      Richard A. Lawhern, PhD | Meds
    • Nobody wants this job. Should physicians stick around?

      Katie Klingberg, MD | Physician
    • The vital importance of climate change education in medical schools

      Helen Kim, MD | Policy
    • The fight for reproductive health: Why medication abortion matters

      Catherine Hennessey, MD | Physician
    • Resetting the doctor-patient relationship: Navigating the challenges of modern primary care

      Jeffrey H. Millstein, MD | Physician
  • Recent Posts

    • The surprising power of Play-Doh in pediatric care: How it’s bringing families together

      Alexander Rakowsky, MD | Conditions
    • Breaking free from gaslighting [PODCAST]

      The Podcast by KevinMD | Podcast
    • The pros and cons of using ChatGPT for your health care needs

      Liudmila Schafer, MD | Tech
    • Dr. Glaucomflecken for president!

      Aaron Morgenstein, MD & Amy Bissada, DO & Corinne Sundar Rao, MD | Physician
    • What is driving physicians to the edge of despair?

      Edward T. Creagan, MD | Physician
    • Do residents deserve the title of physician?

      Anonymous | Physician

MedPage Today Professional

An Everyday Health Property Medpage Today iMedicalApps
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

The discrimination against nurse practitioners must stop
28 comments

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...